Links between Infectious Diseases and Cardiovascular Disease: A Growing Body of Evidence

Kim Curry; Lauren Lawson


Journal for Nurse Practitioners. 2009;5(10):733-741. 

In This Article

Abstract and Introduction


It is widely acknowledged that a systemic inflammatory process is involved in atherogenesis leading to subsequent cardiovascular disease (CVD). Several types of microbes have been implicated as possible causative agents in acquired CVD. This article reviews current and emerging links established between specific microorganisms and cardiac vessel and other vascular damage. Studies are reviewed that have investigated a possible role for antibiotics in treatment and prevention; other potential primary and secondary preventive measures are then explored. Nurse practitioners have an important role in recognizing and effectively managing the multiple complex processes involved in the development of CVD.


Cardiovascular disease (CVD) is the leading cause of death in industrialized nations. In the United States and other developed countries, risk factors such as smoking, high blood pressure, and elevated serum cholesterol levels are widely known and accepted as having a causative role in arteriosclerosis and the development of CVD. Much time and effort has been spent by both researchers and clinicians in investigating and attempting to modify these known risk factors. However, there is a growing body of evidence that other modifiable risk factors may also be at work.

It is now widely acknowledged that a systemic inflammatory process is involved in atherogenesis leading to subsequent cardiac vessel disease and other vascular damage. Inflammatory markers such as C-reactive protein (CRP), fibrinogen, tumor necrosis factor alpha (TNF-α), and others can be used to measure systemic inflammation and risk of CVD. Patients with autoimmune diseases characterized by chronic systemic inflammation, such as rheumatoid arthritis (RA) and systemic lupus erythematosis (SLE), demonstrate a significantly increased risk of CVD.

Several types of microbes are now also being implicated as possible causative agents in acquired CVD. A few bacterial agents have been the topic of research for several years. Organisms such as the spirochetes Borrelia burgdorferi (Lyme disease) and Treponema pallidum (syphilis), and flagellated bacteria such as the streptococci have well-recognized atherosclerotic potential. Now, additional studies are beginning to shed light on the possible role played by other bacterial and viral illnesses and the later development of atherosclerosis or other cardiovascular damage.


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